Blue Shield estimates costs for health care services

Blue Shield introduces new health care services cost estimator.

  One of the big complaints about health care services is not knowing or being surprised by the cost of medical treatment. Blue Shield of California has taken a modest step toward helping plan members determine the cost of health care services with their new treatment cost estimator tool. Initial reports from clients suggest the […]


Blue Shield set to acquire GEMCare of Bakersfield

Blue Shield set to acquire GEMCare Health Plan

Blue Shield has introduced a very competitive Medicare Advantage plan in ten select counties through out California. With the acquisition of GEMCare, Blue Shield will be able to more easily offer a version of their Blue Shield 65 Plus HMO plan in the GEMCare service area. While some Medicare Advantage plans seem to be reducing plan benefits and dropping counties, Blue Shield has been selectively increasing their MA-PD footprint in California.


Few Agents Ready for Covered California Launch

Do you really know who is behind the mask selling you an ACA health plan?

On a recent webinar, Chris Patton, Vice President of SHOP Sales and Agent Management for Covered California, reported that over 15,000 insurance agents have registered to become certified to sell both individual and small group health plans through the California health insurance exchange. Of those thousands of agents, less than 1700 had completed the necessary training for certification only days before the start of open enrollment. In addition, no agents will actually be certified as of the launch on October 1st because agent agreement has not been released.


Covered California Certified Trainer Mocks Affordable Care Act


The misguided training was a missed opportunity to explain the importance of Covered California and how the ACA will help millions of people get access to affordable health insurance and quality care. Instead we were told that health plans were expecting lots of sick people to seek care and they were cutting back on their providers. You know, “those people” were going to use the system they had been shut of for years by insurance companies who were just “following the rules” of being able to deny sick people health insurance. It wasn’t the fault of the insurance company, one trainer opined.


Anthem Blue Cross Releases Transgender Health Plan Benefits

Gender Dysphoria treatment now covered under California health plans.

Anthem Blue Cross California has released information regarding the coverage of medically necessary procedures to treat gender identity disorder, commonly referred to as a person being transgender. Effective immediately, all new and grandfathered plans will cover surgeries, hormone therapy and counseling associated with transitioning from the birth sex to the sex the individual identifies with.


Anthem Blue Cross Coughs Up Medicare Rebates

Anthem Blue Cross opens the cash register to return Medicare Supplement, Medigap, premiums.

Anthem Blue Cross announced that it will issue rebates to members enrolled in their Medicare Supplement plans in five different states. The rebates are a result of the Medicare supplement or Medigap plans failing to meet the medical loss ratios (MLR). Rebate checks being sent out in September will range from $3.51 to $487.08 per member.


Health Agents Launch New Attack on Obamacare

Health insurance agents want to cut the roots of the ACA flower before it has had a chance to bloom.

The National Association of Health Underwriters (NAHU) have signed on to lend their support of a website that seeks to sabotage the Affordable Care Act. The website, The Affordable Coverage Project, is calling for the repeal of the health insurance taxes that made Obamacare originally revenue neutral and finances the tax credits that will make health insurance affordable for millions of Americans.


California Clears MassMutual of Death Master File Abuse, ING Fined

The Death Master File is there to protect beneficiaries.

California Insurance Commissioner Dave Jones announced that his office, along with other states, have reached an agreement with ING over the misuse of the Death Master File. This follows after similar agreements were reached with other carriers earlier this year. ING has agreed to pay $10.7 million to insurance regulators.


Blue Shield of California to Rebate Premiums from 2012

Blue Shield of California will rebate some 2012 premiums.

Health insurance company Blue Shield of California announced that they will be sending rebate checks for certain health insurance plans that didn’t meet the Medical Loss Ratio in 2012. Some large and small employer groups along with individual and family plan members will receive rebates equivalent to .2% up to 3.4% of their 2012 premiums.


United Health Care Leaving California is No Loss

UHC drops California like a pile of poop.

While some industry analysts point a finger at new guarantee issue rules for individual plans as a reason UHC and Aetna are vacating California, both are still retaining their lines of employer group business which IS ALL GUARANTEE ISSUE. It is rather disheartening that UHC and Aetna have taken such a cynical profit driven approach to the individual market in California and in other states.